Ask Dr. Annie K: B12 Injections


Should I get a B12 shot weekly @ 65 years old?


B12 injections have been popular for decades. This is the most fun part of my job as a writer – I learn new things. While researching for this article, I have learned that I am borderline B12 deficient. Enough about me (more later). Let’s get to the facts.

Love+Medicine B12 Injections

What does B12 do?

Vitamin B12, also known as cyanocobalamin, is involved in the metabolism of every cell in the human body. It is key in maintaining proper functioning of the nervous system. B12 cannot be made by the body. People need to get it from food or supplements. Low B12 can be the result of poor intake or poor absorption.

What are common symptoms of low B12?




“Pins and needles” in hands and feet

Balance problems

Muscle aches

Swollen, inflamed tongue


Mood changes

What foods contain B12?



Poultry and eggs

Dairy products

B12 fortified cereals

Who is at risk for low levels?

> 50 year old


People who take common medications for acid reflux (omeprazole, etc)

Strict vegans

Celiac/Crohn’s disease patients

Post weight loss surgery

What is a normal B12 level?

Between 200-900 pg/mL but levels between 150-400 are considered borderline.

Should a 65 year old female get weekly B12 injections?

It depends what the goal is. If you have low B12 and require rapid supplementation, the answer is yes.

Before I would recommend injections to anyone, I would suggest getting a B12 level. It is a simple blood test. As a general rule obtaining vitamins from whole foods is preferable to supplements, depending on your symptoms and medical history. I did not find any medical indication for weekly injections in patients with normal B12 levels.

Although B12 is a water-soluble vitamin which is considered safe, there is no research that demonstrates that asymptomatic people with normal levels should get an injection. Clinical trials do not show a benefit for weight loss or energy in individuals without a deficiency. The pseudoscience queen, Gwyneth Paltrow, will tell you otherwise – keep in mind that she’s the one selling jade eggs to put in your vagina.

Doctors do not routinely check for B12 levels so YOU HAVE TO ASK FOR IT. It is part of my initial work-up for patients with dementia. From now on it will be part of my assessment for all patients.

I had my B12 level drawn last week. The level is 220, borderline deficient. My physician recommended an oral B12 supplement 1mg/day. I will try oral supplements along with dietary changes for now and switch to injection if needed, based on repeat blood-work. Thank you to my reader for asking this question. Otherwise, I would not have known.

Maintaining a healthy blood level of B12 is extremely important – get the blood test. Then discuss the option of injections with your physician. When it comes to your body, make wise decisions based on fact, not fashion.


  1. Elana Lutsky on June 23, 2019 at 11:54 am

    Thanks, that was very informative. I think I eat enough of the right foods but will check it out when I get back.

    • Anne koplin on June 23, 2019 at 5:41 pm

      Hi Elana, you probably do but as we age it’s a matter of absorption..even if I take is adequate, B12 isn’t absorbed as well when we get older.

      • Anne Koplin on June 23, 2019 at 5:46 pm


        {hope your trip is going great:}

  2. terri on June 24, 2019 at 12:43 pm

    I am going to ask to have my B12 level checked next time I see my Dr. Thanks Anne.

    • Anne on June 24, 2019 at 1:40 pm

      Do it! Could explain all those symptoms we were blaming on our job 😂